Monthly Archives: June 2013

I came across a great article by Rajiv Mehta, it was his story about the development and evolution of a health app and what they learnt from its use by consumers over time and their response and continuing development of the app.

What I really, really liked was the 3 lessons they learnt from working closely with consumers. I won’t go into them all here, you can read them for yourself using the link below, but this was the key for me:

OK, in this case the author is talking about adherence to using an app to improve patient health, but the principle applies across medications and other treatments. What pharma and other clinicians fail to appreciate is that they need to understand the total priorities in a person’s life and how they can make adherence fit into the patients life. It is not about getting patients to be compliant and making consumers change their life around their condition. I know taking medications as prescribed is THE highest priority for pharma – for me, that’s what they care about, but for patients it’s about getting on and living life as best they can.

Almost everyday in the media and on websites around the world someone, somewhere, comments and discusses the importance of engaging patients. As if this is something surprising and new!

What is surprising to me, is that the topic continues to be debated, and commentators continue to try to persuade non believers and key healthcare stakeholders that this has real benefit. And, it’s true, not everyone is convinced it’s a good thing.

The concept has been around for years, and there as many success stories as there are failures, but commentators seem very quick to want to throw out the concept without completely understanding that it is the ‘how’ that is most likely at fault. Clearly, not every patient wants to be engaged, but certainly many of them do. Just look at the number of folks who look at health related topics on the internet – a recent study by Pew Internet found that 80% of internet users, or about 93 million Americans have searched for health related information on line. That is a lot of interested healthcare consumers!

So it is definitely the ‘how’ that causes the problem. Each of us have a different view about how we want to be engaged, be it in healthcare or anything else. So flexibility is the key, and what I see so often is that engagement is clinical code for compliance: ‘we need to educate this patient so that they understand their condition and follow their treatment’. But, to be honest, it simply does not work like that. Clinicians still have that scientific, data driven, clinical view of the world and continue to struggle with the idea that they are working with people, most of who have a strong notion of what health means to them. And it may not agree with accepted clinical thinking. But it is their health and their body, and clinicians need to better understand that a good outcome for one patient may not be good for another in some cases.

So, as with all things in healthcare, when we are speaking about engaging patients it needs to fit the individual patient’s view of what engagement means to them. For some, light touch, for others more information and data, while others may just want to feel heard. Anyway, patient engagement is not one size fits all, and if we are to engage patients in any meaningful way we need to work with all stakeholders to change behavours and rewards, and actively encourage patients to become more involved in their health management.

If we can do this, we will have better health outcomes for patients while driving down the cost of healthcare. For pharma, it may even have the benefit of improving adherence and increasing their profitability.

It seems that is quite hard to recruit patients into taking part in a clinical trial. And getting harder too.

For those of you who don’t know, these are clinical studies, usually carried out by clinical research organisation on behalf of a pharmaceutical company. They typically involve recruiting patients that match a specific criteria set down by the pharma company, and they are either provided the drug being tested or a placebo sugar pill and the results monitored. Clearly the patient does not know if they are receiving ‘the real deal’ or just a sugar pill. In return the patient receives on going free medical checks, the medication for free and usually some form of fee.

Additionally the patient needs to submit to a series, sometimes quite a rigorous series of tests throughout the course of the trial. And, of course, you may be lucky and receive a new, highly effective new treatment for your condition. Or not!

So, on a recent trip back to the US I was driving down from New York and on the radio that I was only half listening to, there was an advertisement from a CRO (Clinical Research Organisation) recruiting people to take part in an investigational trial. It sort of caught my attention, so I listened a bit more closely to the last part of the advert. The thing that really caught my attention was the ending. It went something like this ‘call this number today if you qualify and be part of this investigational trial’.

I am sure the advert was better than that, but the way it finished left me feeling like it was a competition, and if you met their specifications you were a winner. I felt like this was a very typical mistake made by companies that work in this area and was a fine example of an internal company view without really appreciating the customers perspective.

What the advert should have said was ‘if you are unfortunate enough to have this condition we may be able to help you’. But this advert was only looking at the benefits for the pharma company. We need test subjects, we will pay them money to participate. They may or may not receive the drug they need, but this will help us bring this drug to market or not.

It’s no wonder people don’t want to participate in trials. Forget the ethical issue of folks not receiving a medication that they need, or even telling them they are taking the medicine or not, but pharma and CRO’s need to understand the patients perspective better.